QUESTION: My question pertains to the assessment of alteration of motion segment integrity using magnetic resonance (MR) studies of the cervical spine with flexion–extension views. I was asked to evaluate the consequences of an injury that occurred two years ago when a woman in her mid-fifties stumbled while walking. She landed on bilateral hands and bilateral knees and struck her forehead against the ground. She received no treatment until after being laid off a month later and having sought legal counsel who referred to a family physician. Reportedly she complained of neck and wrist pain (right greater than left). She had limited cervical range of motion and was diagnosed with posttraumatic head concussion, cervical sprain / strain, and wrists sprains / strains. She was treated with medications, a TENS unit, and manipulation. Cervical x-rays revealed degenerative disk disease...
